Chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is a cancer of the blood cells. It's a type of leukemia in which the bone marrow makes too many young white blood cells called lymphocytes.

In CLL, some of these lymphocytes grow abnormally and don't mature or die off as they should. Instead, they become leukemia cells. These leukemia cells slowly crowd out normal blood cells in the blood, bone marrow, lymph nodes, and spleen.

CLL is also called chronic lymphoblastic leukemia. It usually gets worse slowly.

CLL often doesn't cause any symptoms. When it does, they may include swollen lymph nodes; fatigue; a feeling of fullness below the ribs; weight loss for no clear reason; and fever, chills, and night sweats. If it gets worse, it may cause anemia, infections, and easy bruising or bleeding.

Your doctor will ask about your past health, your family history, and any symptoms you've had. The doctor will do a physical exam and check for swollen lymph nodes or an enlarged spleen or liver.

You'll have tests, which may include:

• Lab tests, including a complete blood count.
• Imaging tests, such as a CT scan.
• Tissue tests, such as a bone marrow aspiration and biopsy.
• Genetic tests that look for changes in your genes and chromosomes.
• Heart tests to check how well your heart works, such as an echocardiogram.

CLL isn't always treated right away. Treatment choices for CLL include:

• Watchful waiting.
• Targeted therapy.
• Chemotherapy and immunotherapy (chemoimmunotherapy).
• A stem cell transplant.

When CLL doesn't respond to treatment, or if it comes back after you haven't had symptoms for a while, your doctor will discuss your options for more treatment. Or your doctor may recommend that you join a clinical trial for new treatments.

When you have CLL, your body isn't able to fight infections very well. You and your doctor need to watch for any signs of infections, such as pneumonia or yeast infections. Early treatment of these and other infections will help you live longer. You can sometimes prevent certain infections or keep from getting very sick by staying up to date on your COVID-19 vaccines and getting a flu shot or a pneumonia vaccine. Your doctor also may give you antibiotics to prevent infection while you're being treated for leukemia.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu shot every year. Stay up to date on your COVID-19 vaccines.
• Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.